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General NPI Number Information
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NPI Number | 1396660627
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Entity Type | Organization
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Legal Business Name | RESTORATION COMMUNITY DEVELOPMENT ORGANIZATION
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 2815 W SUNSET BLVD STE 204
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City | SPOKANE
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State | WA
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Zip | 99224-1109
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Country | US
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Telephone | 509-279-3249
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2581
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City | SPOKANE
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State | WA
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Zip | 99220-2581
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Country | US
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Telephone | 509-279-3249
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ANDRE DOVE
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Credential | DR.
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Telephone | 509-279-3249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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